IS FATNESS OR FITNESS THE BEST PREDICTOR OF CARDIOVASCULAR DISEASE RISK PROFILE IN HEALTHY MEN?

Abstract

In humans, body fatness and aerobic fitness often are inversely coupled making it difficult to isolate the respective contributions of these putative influences to cardiovascular disease (CVD) risk factors. PURPOSE To determine the independent relations of fatness and aerobic fitness to CVD risk factors among healthy men. METHODS We measured blood pressure (systolic, diastolic, ankle-brachial index), vascular health (carotid/femoral intima-media thickness (IMT), aortic pulse wave velocity, augmentation index), left ventricular mass normalized to fat-free mass, lipids (total cholesterol, HDL-C, LDL-C, triglycerides), metabolic (fasting insulin and glucose, insulin sensitivity) and plasma hemostatic (plasminogen activator inhibitor-1 and tissue plasminogen activator (tPA) activity and antigen, fibrin D-dimer and fibrinogen) factors in 141 healthy nonsmoking men (age: 48.8 ± 1.3 yr, mean ±SE). Multiple linear regression was used to determine the independent contributions of aerobic fitness (maximal oxygen consumption) and % body fat (DXA) on CVD risk factors after correcting for age. Squared part correlations were used to determine the portion of variance in CVD risk factors explained uniquely by aerobic fitness and total adiposity. RESULTS Aerobic fitness was independently associated only with carotid IMT (r = − 0.13) and tPA activity (r = −0.29, p < 0.05). In contrast, total body fatness was consistently associated with hemostatic (r = − 0.20 to 0.44), lipid (r = −0.25 to 0.30) and metabolic (r = −0.42 to 0.36) CVD risk factors (p < 0.05). Waist circumference, an indicator of total abdominal adiposity, generally was as strong or stronger of a predictor of CVD risk factors as total body fatness. CONCLUSION Overall, fatness is a stronger independent predictor of CVD risk factors than aerobic fitness among healthy men varying in age. These results provide experimental support for the concept that being fat is more consistently and strongly linked to CVD risk factors than being unfit. NIH AG16071, AG19365, AG13038, AGO6537 and RR-00051.